Cortical plasticity is correlated with cognitive improvement in Alzheimer’s disease patients after rTMS treatment

• Published in: Brain stimulation Vol. 14; no. 3; pp. 503 - 510
• Main Authors: Li, Xingxing, Qi, Gangqiao, Yu, Chang, Lian, Guomin, Zheng, Hong, Wu, Shaochang, Yuan, Ti-Fei, Zhou, Dongsheng
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2021; Elsevier
• Subjects: Alzheimer’s disease; Cognition; Cortical plasticity; Long-term potentiation; rTMS; Transcranial magnetic stimulation; Cognition; Transcranial magnetic stimulation; Alzheimer’s disease; Cortical plasticity; rTMS; Long-term potentiation
• ISSN: 1935-861X; 1876-4754; 1876-4754
• DOI: 10.1016/j.brs.2021.01.012

Repetitive transcranial magnetic stimulation (rTMS) has been widely used in non-invasive treatments for different neurological disorders. Few biomarkers are available for treatment response prediction. This study aims to analyze the correlation between changes in long-term potentiation (LTP)-like cortical plasticity and cognitive function in patients with Alzheimer’s disease (AD) that underwent rTMS treatment. A total of 75 AD patients were randomized into either 20 Hz rTMS treatment at the dorsolateral prefrontal cortex (DLPFC) group (n = 37) or a sham treatment group (n = 38) for 30 sessions over six weeks (five days per week) with a three-month follow-up. Neuropsychological assessments were conducted using the Mini-Mental State Examination (MMSE) and Alzheimer’s Disease Assessment-Cognitive Component (ADAS-Cog). The cortical plasticity reflected by the motor-evoked potential (MEP) before and after high-frequency repetitive TMS to the primary motor cortex (M1) was also examined prior to and after the treatment period. The results showed that the cognitive ability of patients who underwent the MMSE and ADAS-Cog assessments showed small but significant improvement after six weeks of rTMS treatment compared with the sham group. The cortical plasticity improvement correlated to the observed cognition change. Cortical LTP-like plasticity could predict the treatment responses of cognitive improvements in AD patients receiving rTMS intervention. This warrants future clinical trials using cortical LTP as a predictive marker. •High-frequency rTMS is an effective, non-invasive treatment for cognitive improvements.•There is a correlation between LTP-like plasticity and cognitive function changes following rTMS treatments on patients with AD.•Cortical LTP-like plasticity could predict treatment responses. This warrants future clinical trials using cortical LTP as a predictive marker.